Q:

Live in help can be provided by a traditional home health care agency or hired by you through an employment service. Let’s look at both types of care providers.

If you hire a traditional home health agency, you employ the agency and they guarantee that their employees will be present 24 hours a day, 7 days a week. The employees are required to speak English, have references, and in Illinois, the agency has done a background check on the individual to determine whether or not the person has a criminal record. The agency requires documentation of patient care and visits regularly (usually once a month) to see that the employee is performing to the agency’s standards of care. The agency handles payroll, insurance and benefits for the employee. They tend to be more expensive per day, but worth it if you don’t want a lot of hassle.

Employment services will place a live in caregiver in your home as well. These individuals are often recent immigrants who pay a placement fee. The employer (you) also pays a fee to the employment agent for the referral. These individuals are not considered professional caregivers, but some may have had health care experience or training in their country of origin. The employment service can do some screening but background checks, references, and ongoing supervision of the patient’s care are the responsibility of the employer, not the agent. The individual may not speak English. This may work for some families where the patient was raised in a bilingual home, or their first language was not English. It may not work for other families. The employer (you) will have to arrange coverage for the employee’s time off or if the employee quits. These services are much less expensive, but you must assume responsibility for payroll, taxes and worker’s compensation insurance. Even with the added expenses of employer taxes and insurance, this option is still less expensive than a traditional agency.